Low parental literacy is associated with worse asthma care measures in children

Abstract

Objective: To determine whether parental literacy is related to emergency department visits, hospitalizations, and days of school missed for children with asthma.

Methods: We performed a retrospective cohort study at a university pediatric clinic. We enrolled children between 3 and 12 years old with a diagnosis of asthma and a regular source of care at the site of the study and their parent or guardian. Primary asthma care measures included self-reported rates of emergency department visits, hospitalizations, and days of school missed. Secondary asthma care measures included rescue and controller medication use, classification of asthma severity, and parental asthma-related knowledge.

Results: We enrolled 150 children and their parents. Twenty-four percent of the parents had low literacy. Children of parents with low literacy had greater incidence of emergency department visits (adjusted incidence rate ratio [IRR] 1.4; 95% confidence interval 0.97, 2.0), hospitalizations (IRR 4.6; 1.8, 12), and days missed from school (IRR 2.8; 2.3, 3.4) even after adjusting for asthma-related knowledge, disease severity, medication use, and other sociodemographic factors. Parents with low literacy had less asthma-related knowledge, and their children were more likely to have moderate or severe persistent asthma and had greater use of rescue medications.

Conclusions: Low parental literacy is associated with worse care measures for children with asthma.

Conflict of interest statement

Potential conflicts of interest: Drs. DeWalt and Pignone have received grants and honoraria from Pfizer, Inc. for work related to health literacy. No product of Pfizer is mentioned in this manuscript.

Figures

Figure 1

Recruitment of the cohort.